This review article discusses the clinical syndrome of alcohol dependence, highlighting its complex nature and the challenges in defining it. The authors note that while much is still at the clinical impression stage, there are recurring patterns in patients' experiences that suggest the presence of a syndrome. They emphasize that the syndrome is not a fixed condition but is influenced by social and personal factors, making it plastic rather than rigid. Key elements of the syndrome include a narrowing of the drinking repertoire, the salience of drink-seeking behavior, increased tolerance to alcohol, repeated withdrawal symptoms, relief or avoidance of withdrawal symptoms through further drinking, subjective awareness of a compulsion to drink, and reinstatement of the syndrome after abstinence. Each of these elements can vary in severity and are influenced by personal and social factors. The authors also discuss the natural history of the syndrome, noting that it can progress from mild to severe dependence, with some cases potentially regressing. They stress the importance of distinguishing between dependence and other forms of drinking, emphasizing that dependence is a clinical syndrome with specific characteristics that should be assessed in relation to primary symptoms rather than secondary damage. The article also touches on the implications of alcohol dependence for research and clinical practice, suggesting that a better understanding of the psychobiological basis of the syndrome could lead to more effective treatments. The authors conclude that alcohol dependence is a complex condition that requires careful clinical assessment and that it should be viewed as a disease rather than a mere social problem. They also note that the term "alcoholism" can be misleading due to its broad usage and the need for more precise definitions. The article references various studies and discussions with colleagues, highlighting the importance of ongoing research in understanding the syndrome.This review article discusses the clinical syndrome of alcohol dependence, highlighting its complex nature and the challenges in defining it. The authors note that while much is still at the clinical impression stage, there are recurring patterns in patients' experiences that suggest the presence of a syndrome. They emphasize that the syndrome is not a fixed condition but is influenced by social and personal factors, making it plastic rather than rigid. Key elements of the syndrome include a narrowing of the drinking repertoire, the salience of drink-seeking behavior, increased tolerance to alcohol, repeated withdrawal symptoms, relief or avoidance of withdrawal symptoms through further drinking, subjective awareness of a compulsion to drink, and reinstatement of the syndrome after abstinence. Each of these elements can vary in severity and are influenced by personal and social factors. The authors also discuss the natural history of the syndrome, noting that it can progress from mild to severe dependence, with some cases potentially regressing. They stress the importance of distinguishing between dependence and other forms of drinking, emphasizing that dependence is a clinical syndrome with specific characteristics that should be assessed in relation to primary symptoms rather than secondary damage. The article also touches on the implications of alcohol dependence for research and clinical practice, suggesting that a better understanding of the psychobiological basis of the syndrome could lead to more effective treatments. The authors conclude that alcohol dependence is a complex condition that requires careful clinical assessment and that it should be viewed as a disease rather than a mere social problem. They also note that the term "alcoholism" can be misleading due to its broad usage and the need for more precise definitions. The article references various studies and discussions with colleagues, highlighting the importance of ongoing research in understanding the syndrome.